Many changes mandated by the Patient Protection and Affordable Care Act (PPACA) are already underway, but health care still has time for a deep breath before the biggest change of all: In 2014, the insured-patient base is set to explode, driven by limits in payors' ability to deny coverage, by expansion of Medicaid, by the launch of state health-insurance exchanges, and by the hotly debated individual mandate.
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Medical Management Professionals, Inc. (MMP), a leading national firm providing billing and practice management services to radiology, introduces two technologies that will fundamentally change the way practices communicate, examine data and make strategic decisions: MMPact® Analytics, a decision support application that offers customized score boarding and real time data reporting capabilities; and MMPact® Practice Point, a practice management software with a collaborative platform that allows practices to conduct business electronically through real-time information exchange.
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Hospitals are inching their way back to full-fledged outpatient reimbursement for inpatient claims denied by Medicare auditors because the patient could have been treated in a less intensive setting. CMS announced on Nov. 15 a demonstration project to allow “rebilling” at about 10% of the nation’s hospitals, though hospitals have already made headway on this issue through appeals. Administrative law judges (ALJs) generally agree that hospitals should be able to resubmit a Part A inpatient claim to Part B if it’s denied solely based on the site of the service — an inpatient bed — and not the service itself, says Washington, D.C., attorney Don Romano, former director of the CMS Division of Technical Payment Policy.
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In making the decision to take or pass on a new hospital contract, radiology groups often let emotion supersede reason, Jana Landreth, CPA, direct of practice management at Medical Management Professionals, Inc (MMP), Atlanta, Georgia, explains.  “The factor that most often challenges these decisions is emotion, “she says.  “It manifest itself as the desire to grow, without accounting for what is feasible-or the inverse, the fear of growing, when it is what your practice needs.”
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Starting in 2015, penalties will be assessed if meaningful use under the current law is not shown. The HITECH Act established programs under Medicare and Medicaid to provide incentive payments for the meaningful use of certified EHR technology. These payments will be made to eligible professionals (EPs) and eligible hospitals (EHs) as they adopt, implement, upgrade, or demonstrate meaningful use. While there has been much discussion about earning meaningful use incentive payments, it should be noted that this is not a voluntary program—only participation in the incentive program is voluntary.
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Relative Value Units (RVUs) are still considered a taboo topic within many radiology
groups, but groups that are still battling over whether to use RVU data should reconsider
their potential. RVUs are often considered negatively as a measure of physician
productivity that can devalue a physician's workload. In essence, RVU data have
traditionally been applied objectively in a subjective context, often valuing (or devaluing)
individual physicians' worth. In addition, RVUs illustrate the value Medicare assigns to a
CPT code for payment, with which the radiology community may or may not agree.
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The passage of the Patient Protection and Affordable Care Act made accountable-care organization (ACO) one of the most feared buzzwords since capitation, but if the concept of ACOs is framed within its larger context, which is a nationwide collaborative-care initiative with federal support, participation begins to seem less onerous.
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In this four-part series, representatives from Medical Management Professionals Inc., an Atlanta-based company that partners with ZirMed to provide billing services and revenue cycle management and practice management solutions to hospital-based doctors and practices, discuss operations, HIPAA 5010 and ICD-10 implementation, industry changes, and selection of an RCM partner. Here, MMP’s Jeff Fowler talks about choosing an RCM partner.
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MMP, a national firm providing billing and practice management services to radiologists and imaging centers, has been awarded an exclusive full practice management contract with Houston, Texas-based Singleton Associates, PA. The practice is a sub-specialized radiology group of more than 50 board certified radiologists with expertise in all diagnostic and therapeutic radiologic modalities for both adult and pediatric patients.
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In this four-part series, representatives from Medical Management Professionals Inc., an Atlanta-based company that partners with ZirMed to provide billing services and revenue cycle management and practice management solutions to hospital-based doctors and practices, discuss operations, HIPAA 5010 and ICD-10 implementation, industry changes, and selection of an RCM partner. Here, MMP's Randal Roat and David Myrice talk about the industry.
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In this four-part series, representatives from Medical Management Professionals Inc., an Atlanta-based company that partners with ZirMed to provide billing services and revenue cycle management and practice management solutions to hospital-based doctors and practices, discuss operations, HIPAA 5010 and ICD-10 implementation, industry changes, and selection of an RCM partner. Here, MMP's David Stone talks HIPAA 5010 and ICD-10.
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This article is third in a four-part series about health-care reform's impact on radiology. In the short term, radiology practices might have less to fear from the accountable-care organization (ACO) than from a similar term: the acute-care episode (ACE). That is the contention of Ed Gaines, JD, chief compliance officer for Medical Management Professionals Inc (MMP), Atlanta, Georgia.
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Increased regulations and higher fixed costs have many private radiology clinics across the U.S. choosing to affiliate with local hospitals or healthcare systems. Doing so, however, has raised new questions on the revenue side. Does it become easier or more difficult for a radiology practice to maximize its financial efficiency once it joins a larger healthcare system? What are the pitfalls — and the opportunities? In this four-part series, representatives from Medical Management Professionals Inc., an Atlanta-based company that partners with ZirMed to provide billing services and revenue cycle management and practice management solutions to hospital-based doctors and practices, discuss operations, HIPAA 5010 and ICD-10 implementation, industry changes, and selection of an RCM partner.
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CMS funding for recovery audit contractors (RACs) will almost double in fiscal year 2012, which starts Oct. 1. The investment in RACs will rise from $259 million in 2011 to $500 million, a sign they will recoup more of the green stuff from providers because RACs are paid only when they identify Medicare errors that survive provider appeals, according to former RAC executive Vickie Axsom-Brown. And RACs — which CMS now calls “recovery auditors” — are not the only Medicare auditors armed with generous budgets and new overpayment-recovery strategies.
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There is much discussion about Accountable Care Organizations (ACOs), or "new" payment models legislated under PPACA (Health Care Reform). The program, which is starting January 1, 2012, is envisioned to be very diverse in terms of membership and structure, but ultimately will be primary care oriented.
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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to radiologists and imaging centers, in conjunction with ImagingBiz will deliver a complimentary webinar on data integration strategies that create whole business solutions.
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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to hospital-based physicians, has made requisite software changes to comply with the HIPAA ANSI ASC X12 Version 5010 format change, obtained third-party certification for claims submittal, and is currently testing and submitting claims to Medicare carriers and other commercial payors that are also using the new format.
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MMP, a national firm providing billing and practice management services to radiologists and imaging centers, has been awarded an exclusive full practice management contract with Tennessee Imaging Consultants located in Springfield, Tennessee.

Tennessee Imaging Consultants is a radiology group that provides diagnostic imaging and radiology services to NorthCrest Medical Center.
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The results of this year’s Medical Management Professionals, Inc. (MMP)’s annual physician survey are in and it shows that hospital-based radiology practices are receiving their highest amount (37%) of reimbursements from Medicare. Though not overwhelming, the next highest, BCBS, accounted for only 17%. Overall MMP found that the payor mix was split among nine different sources from the government to private insurance to even self pay.
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Like it or not, Medicare remains the largest component of radiology practices’ payor mix, at 37% of the total. So reveals the 10th annual physician survey conducted by Medical Management Professionals, Inc. (MMP), a provider of billing and practice management service to radiology groups and imaging centers. Intended as an imaging industry snapshot, the survey includes information gleaned from shareholder and non-shareholder physicians in radiology practices with which the Atlanta, Georgia-based company works.
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Radiology practices trying to recruit the most promising young talent—particularly those facing the retirement of multiple baby-boom–generation radiologists—will inevitably face decisions related to benefits planning. The most contentious of these might be the practice's retirement-plan offering, as the recent vagaries of the stock market have exposed both the risks and benefits associated with the two most common types of retirement plans.
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Medical Management Professionals, Inc. (MMP) recently conducted its tenth annual physician survey to obtain beneficial radiology industry data for practice payor mix percentages, procedure statistics, work RVUs and retirement/benefits plans from hospital-based radiology practices. Since 2001, MMP has been extracting relevant client data from its internal database in an effort to survey its clients and provide them with a state-of-the-industry snapshot. This year, the company reviewed data from both shareholder and non-shareholder physicians in radiology practices it works with.
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While creating an operating budget may not be an organization's overarching goal, it is an integral part of strategic planning that requires a radiology practice to look forward, see the desired results, and try to set a course to achieve them. Mapping out a strategic plan involves goal setting, a plan of action to achieve the goals, and monitoring systems to measure the efforts intended to achieve those goals. Operating budgets can tangibly show the results of numerous decisions that have been made and often act as a report card on the success of any given strategy. The intent of this article is to define and illustrate the necessary components that radiology practices must consider as they carve out a budget.
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Medical Management Professionals, Inc. (MMP) recently conducted its tenth annual physician survey to obtain beneficial anesthesiology industry data for practice payor mix percentages, case statistics and retirement/benefits plans from hospital-based anesthesiology practices. Since 2001, MMP has been extracting relevant client data from its internal database in an effort to survey its clients and provide them with a state-of-the-industry snapshot. This year, the company reviewed data from both shareholder and non-shareholder physicians in anesthesiology practices it works with. Below is a listing of averaged MMP client data by category that was compiled from 2010.
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Medicare's Acute Care Episode demonstration program will bundle all related Part A and B patient services into an episode of care with a single global payment. The program will alter how billing, collections, and accounts receivable are handled, with clear positive and negative aspects. Emergency departments have to find ways to maintain stability as they consider new payment options and prepare for national implementation of the program.
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This article is the first in a two-part series about how radiology practices can derive superior business intelligence from their existing coding and payment data. Historically, radiology practices have looked at CPT® code volume as a measure of work. As Greg Thomson, CPA, executive vice president of Medical Management Professionals, Inc (MMP), Atlanta, Georgia, explains, “It is the widget we have used to measure the work performed by our physician clients, and also a measure of the work performed in the billing office.” Thomson and his colleague Jana Landreth, CPA, MBA, would argue, however, that there are better ways to measure physician work—and that practices are often neglecting to pursue the full range of business intelligence available from analysis of these kinds of data.
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Radiology is a mature business market that is currently witnessing consolidation, erosion of profit margins, and commoditization. Medical imaging in particular is undergoing its consolidation period after many years of unparalleled growth, which in turn results in the need to do more with less. Competition also remains fierce and steady, and practices are undergoing increased payor scrutiny which means the search for revenue predictability and certainty is elusive. However, one positive has emerged. At the same time the radiology industry is experiencing unprecedented pressure, practices have access to evolving technology that can produce abundant, powerful data.
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As specifics of how health-care reform’s provisions will be executed increasingly come into focus, the radiology industry awaits word on how it will be required to demonstrate quality under the new order. “By 2015, physician payments can be reduced by 1.5% if physicians are not reporting under the Physician Quality Reporting System (PQRS),” according to Ed Gaines, chief compliance officer for Medical Management Professionals, Inc (MMP), Atlanta, Georgia. He says, “We are moving from a pay-for-reporting to a pay-for-performance mentality and payment system.”
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MMP, a national firm providing billing and practice management services to radiologists
and imaging centers, has been awarded an exclusive full practice management contract
with Norwalk Radiology Consultants, P.C. located in Norwalk, Connecticut.

Norwalk Radiology Consultants, P.C. is a 14 member radiology group providing
professional services to Norwalk Hospital and Norwalk Radiology and Mammography
Center, the largest outpatient imaging center in Fairfield County.
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In an effort to reduce compliance risks, radiology practices considering the employment
of radiology practitioner assistants (RPAs) or radiology assistants (RA's) should become
knowledgeable about the appropriate role of the radiology extender existing payment
rules with applicable payors, state licensure requirements and potential liability issues
that emerge with extender utilization.
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It is no surprise that the radiology industry is facing reimbursement challenges and
management difficulties that force practices to analyze the effectiveness and efficiency
of their operations. As Bob Dylan sang, "the times, they are a changing," and drilling
deeper into the details of a radiology business has become more important than ever.
This article will challenge radiologists to closely analyze their business, holding them
accountable for developing a firm plan of action that, if implemented, will strengthen their
practice.
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In today's challenging business environment, it is more critical than ever before that
radiology groups engage in strategic planning. Ironically, the same factors that make
strategic planning so necessary to a group's survival also make it difficult to dedicate
resources to the process. Those practices that do carve out the necessary time will
see their efforts pay dividends in the future. Though the process can be challenging,
the application of best practices (based on experience) can significantly augment its
effectiveness.
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The use of scribes has gained traction during the transition to electronic health records,
but there are compliance and other risks related to their use. Scribes may make
documentation errors that translate into billing errors or even step over the line into
providing clinical care. Scribes are human tape recorders who accompany physicians
to patient encounters and document their descriptions of diagnoses and treatment.
Physicians talk out loud as they interact with patients, and scribes enter the information in
the EHR system in real time.
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In an editorial in GovHealthIT, David Stone, executive vice president of Medical
Management Professionals, discussed the "significant issues and potential concerns"
that hospital-based practices may face as they transition to ICD-10. Mr. Stone
recommended hospital-based practices keep an eye on cost considerations. According
to the report, ambulatory coders who need to learn only ICD-10-CM require around eight
hours of training, which is estimated to cost around $110 in training and $440 in lost work
time per coder.
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There are multiple factors that might lead a radiology group to consider restructuring,
but the majority of changes to a group's governance are prompted by breakdowns in
communication. This issue becomes particularly prevalent as groups expand; a single-
site, hospital-based group of radiologists is able to handle critical decision making in a
relatively casual manner, but a multisite group with a great number of partners will begin
to experience potential internal dissent caused by poor communication.
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Physician groups face formidable challenges in the current healthcare environment.
Growing regulatory complexity, continued reimbursement cuts and intensifying
competition can undermine and destabilize even the strongest practice.
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MMP, a national firm providing billing and practice management services to radiologists and imaging centers, has been awarded a full practice management contract with Diagnostic Imaging Northwest (DINW), located in Portland, Oregon.

DINW has 10 board certified physicians on staff and each is specialized in performing and interpreting a broad range of advanced medical imaging and interventional radiology exams and procedures.
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MMP, a national firm providing billing and practice management services to anesthesiology practices, has been awarded an exclusive coding contract with UT Health Science Center at San Antonio. 

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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to hospital-based physician practices, has promoted George Ehrhardt, CPA to vice president of practice management in its West region.
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Radiology practices are currently in a climate of increasing competition that
requires self-analysis and more in-depth views of market trends that can be
compared to their own business models. Whether it is the emerging relationship
between teleradiology groups and hospitals, competitive hospital contract bids, or
the independent formation of radiology groups, radiology practices are realizing
that the time for "doing what has always been done" is over.
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How the majority of provisions from the Patient Protection and Affordable Care Act (PPACA) will affect health care (in general) and radiology (in particular) remains to be seen; with the most sweeping changes still pending in the coming years, providers are holding their breaths. Ed Gaines, chief compliance officer for Medical Management Professionals Inc (MMP), Atlanta, Georgia, says, “The uncertainty is what makes it scary. There are over a thousand references in the PPACA to the words ‘the secretary [of HHS] shall.’
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Most emergency medicine practices may readily admit that chart reconciliation is an important process to prevent lost charges for services provided. Many practices may not be aware that even small miss-rate percentages of charges can create large pockets of revenue loss. If implemented and maintained, chart reconciliation allows emergency medicine practices to fill in gaps on lost charges and reduce risks for lost revenue.
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MMP, a national firm providing billing and practice management services to emergency department practices, has been awarded an exclusive coding contract with Mercy Iowa City Emergency Department located in Iowa City, Iowa.

Mercy Iowa City Emergency is a hospital-based emergency practice that has 12 physicians on staff.
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Radiology practices are currently in a climate of increasing competition that requires self-analysis and more in-depth views of market trends that can be compared to their own business models. Whether it is the emerging relationship between teleradiology groups and hospitals or competitive hospital contract bids or the independent formation of radiology groups, radiology practices are realizing that the time for “doing what has always been done” is over.
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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to anesthesiology practices and providers, has met criteria deeming it a preferred vendor with the Anesthesia Quality Institute (AQI).
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MMP, a national firm providing billing and practice management services to radiologists and imaging centers, has been awarded an exclusive full practice management contract with Renaissance Medical Imaging in Edinburg, Texas.
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Since the Health Information Technology for Economic and Clinical Health (HITECH) Act went into effect in February 2010, regulations regarding health-care data security have become more stringent than ever before. For instance, the DHHS secretary is required to publish the names of covered entities that have experienced any data breach involving 500 or more individuals. This list of breaches is publicly available on the HHS website, and it now includes more than 200 covered entities.
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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to radiologists and imaging centers, will join ImagingBiz’s affiliate program again in 2011.
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Medical Management Professionals, Inc. (MMP), a national firm providing billing and practice management services to radiologists and imaging centers, is pleased to announce that it has renewed its Gold level sponsorship commitment with the Radiology Business Management Association (RBMA) for 2011. MMP has been a supporter and sponsor of RBMA since 2008.
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